【摘要】 目的　探讨血清糖链抗原２４２（ＣＡ２４２）、神经元特异性烯酸化酶（ＮＳＥ）及癌胚抗原（ＣＥＡ）等 ３项指标联合检测 对肺癌的诊断价值。方法采用酶联免疫法。结果肺癌组（ｎ＝８７）３项指标均明显高于结核组（ｎ＝３０）（Ｐ＜０．０１）。以健康对 照组（ｘ＋２ｓ）值为肺癌诊断的临界值（ＣＡ２４２为 ２０Ｕ／ｍｌ，ＮＳＥ为 ２０ｕ ｇ／１，ＣＥＡ为 ５ｎｇ／ｍｌ），则 ＣＡ２４２对肺腺癌（ＡＣ），鳞癌 （Ｓｑ）及小细胞肺癌（ＳＣＬＣ）的敏感性分别为 ６５．６％、４２．８％及 ３３．３％，特异性均为 ９３．８％。ＮＳＥ的敏感性分别为 ３１．３％、４２．８％ 及７０．４％，特异性均为９５．２％。ＣＥＡ的敏感性分别为７５．０％、５３．５％及５５．６％，特异性均为９５．２％。３项指标中，如以１项阳性作 为肺癌的诊断依据，则 ＡＣ、Ｓｑ、ＳＣＬＣ的阳性率可分别达 ９６．９％、９２．９％及 ９２．６％；如选择两项阳性作为诊断依据，则阳性率可达 ７８．１％、５３．５％及６６．７％，而结核组和正常组的假阳性率仅为６．６７％及０．０％；如以３项阳性作为诊断依据，则阳性率分别为 ４０．６％，３９．３％及 ４４．４％，而对照组无１例阳性。结论 ３项指标对不同组?更多还原

【Abstract】 objective To study diagnostic value of simutaneous detection of three tumor markers (carbohydrate chain antigen 242, CA242;neuron-specific enolase, NSE;carcinoembryonic antigen, CEA) in patients with lung cancer. Methods Enzyme-linked immenosorbent assay was adoptd.Results The level of three tumor marker in lung cancer group (n=87) was higher than that of tuberculosis group (n=30) and control group (n=30)(P<0.01).By the value (x+2s)of control group as critical value of lung cancer (CA242 was 20U/ml:NSE was 20ug/l; CEA was sng/ml), the sensitivity of CA242 to lung adenocarcinoma(AC), squamous carcinoma (sq) and small cell lung cancer (SCLC) was 65.6%,42.8% and 33.3% respectively;Specificity was all 93.8%. The sensitiviy of NSE was 31.3%, 42.8% and 70.4% specificity was all 95.2%. The sensitivity of CEA was 75.0%, 53.5% and 55.6% re spectively; specificity was all 95.2%. By one positive index in three tumor markers as diagnostic base on lung cancer, then POsitive rate of AC, Sq and SCLC were 96.9%, 92.9% and 92.6% respechvely. By two positive indexes as diagnostic basis, then the positive rate were 78.l%, 53.5% and 66.7%.But the false positive rate in tuberculosis group and control group were only 6.67% and 0.0%. By three positive indexes as diagnostic basis, then the positive rate were 46.6%,39.3% and 44.4% respectively. But no positive case was found in coneal group. Conclusion The three indexes hare diagnostic value to different tissue types Of lung cancer and simultaneous detection has obvious complementarity.And it can significently improve the sensitivity and specificity in diagnosis of lung cancer and it can provide reliabile base on typing staging and prognosis of lung cancer.更多还原